HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/HB 319 Substance Abuse Service Providers
SPONSOR(S): Criminal Justice & Public Safety Subcommittee, Children, Families & Seniors Subcommittee,
Caruso
TIED BILLS: IDEN./SIM. BILLS: SB 804
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Children, Families & Seniors Subcommittee 16 Y, 0 N, As CS Morris Brazzell
2) Criminal Justice & Public Safety Subcommittee 16 Y, 0 N, As CS Mathews Hall
3) Health & Human Services Committee 21 Y, 0 N Morris Calamas
SUMMARY ANALYSIS
The Department of Children and Families (DCF) administers a statewide system of safety-net services for
substance abuse and mental health (SAMH) prevention, treatment, and recovery. It serves children and adults who
are otherwise unable to obtain these services (such as individuals who are not covered under Medicaid or private
insurance and do not have the financial ability to pay for the services themselves).
DCF licenses substance abuse treatment programs. CS/CS/HB 319 makes it a third-degree felony to willfully and
knowingly make a false representation in a substance abuse service provider license application or to willfully and
knowingly omit any material fact from such license application.
Florida law provides for voluntary certification of recovery residences and recovery residence administrators.
Recovery residences offer drug- and alcohol-free living environments for individuals in recovery. Under the voluntary
certification program, DCF approved two credentialing entities to design the certification programs and issue
certificates. While the certification process is voluntary, Florida incentivizes recovery residences to be certified.
Licensed treatment providers are generally prohibited from referring individuals to non-certified recovery residences.
Licensed service providers may be fined for referring a patient to an uncertified recovery center. The bill requires
licensed service providers who are fined by final order from DCF to pay interest on administrative fines. The bill
requires DCF to immediately suspend the license of a service provider who does not pay such fines, and respective
interest, within 60 days. The bill also requires DCF to immediately suspend the license of a service provider or
service component for not paying an administrative fine plus applicable interest for committing any violation
specified in DCF’s tier-based violation system.
Substance abuse treatment provider employees and recovery residence administrators must undergo a Level 2
criminal background screening. If an individual has committed any disqualifying offense, he or she is disqualified
from employment unless exempted by DCF. The bill allows credentialing entities to determine if an owner, director,
chief financial officer, or administrator of a recovery residence qualifies for exemption from employment
disqualification.
Property development in Florida is governed in part by the Florida Building Code. The bill prohibits a change of
occupancy under the Building Code for a single-family or two-family dwelling that is converted to a certified recovery
residence or an Oxford House solely based upon the conversion.
The bill prohibits a property owner from being required to install a fire sprinkler system in a single-family or two-
family property based solely upon the use of such property as a certified recovery residence or an Oxford House.
The bill has insignificant negative and positive fiscal impacts on DCF, and no fiscal impact to local governments.
The bill provides an effective date of July 1, 2021.
This document does not reflect the intent or official position of the bill sponsor or House of Representatives.
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Background
Mental Health Services in Florida
The Department of Children and Families (DCF) administers a statewide system of safety-net services
for substance abuse and mental health (SAMH) prevention, treatment and recovery for children and
adults who are otherwise unable to obtain these services. SAMH programs include a range of
prevention, acute interventions (e.g. crisis stabilization), residential treatment, transitional housing,
outpatient treatment, and recovery support services. Services are provided based upon state and
federally-established priority populations.
Behavioral Health Managing Entities
In 2001, the Legislature authorized DCF to implement behavioral health managing entities (ME) as the
management structure for the delivery of local mental health and substance abuse services.1 The
implementation of the ME system initially began on a pilot basis and, in 2008, the Legislature
authorized DCF to implement MEs statewide.2 Full implementation of the statewide managing entity
system occurred in April 2013; all geographic regions are now served by a managing entity.3
In FY 2019-2020, the network service providers under contract with the MEs served 274,560
individuals.4
Substance Abuse
Substance abuse refers to the harmful or hazardous use of psychoactive substances, including alcohol
and illicit drugs.5 Substance use disorders occur when the chronic use of alcohol or drugs causes
significant impairment, such as health problems, disability, and failure to meet major responsibilities at
work, school, or home.6 Repeated drug use leads to changes in the brain’s structure and function that
can make a person more susceptible to developing a substance use disorder.7 Brain imaging studies of
persons with substance use disorders show physical changes in areas of the brain that are critical to
judgment, decision making, learning and memory, and behavior control.8
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, a diagnosis of
substance use disorder is based on evidence of impaired control, social impairment, risky use, and
pharmacological criteria.9 The most common substance use disorders in the United States are from the
use of alcohol, tobacco, cannabis, stimulants, hallucinogens, and opioids.10
Substance Abuse Treatment in Florida
1 Ch. 2001-191, Laws of Fla.
2 Ch. 2008-243, Laws of Fla.
3 The Department of Children and Families Performance and Accountability System for Behavioral Health Managing Entities, Office of
Program Policy Analysis and Government Accountability, July 18, 2014.
4 Department of Children and Families, Substance Abuse and Mental Health Triennial Plan Update for Fiscal Year 2019-2020, (Dec.
31, 2020) https://www.myflfamilies.com/service-programs/samh/publications/docs/2019-2020%20Triennial%20Plan%20Update.pdf
(last visited April 16, 2021).
5 World Health Organization, Substance Abuse, http://www.who.int/topics/substance_abuse/en/ (last visited April 16, 2021).
6 Substance Abuse and Mental Health Services Administration, Substance Use Disorders, http://www.samhsa.gov/disorders/substance-
use (last visited April 16, 2021).
7 National Institute on Drug Abuse, Drugs, Brains, and Behavior: The Science of Addiction,
https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/drug-abuse-addiction (last visited April 16, 2021).
8 Id.
9 Supra, note 6.
10 Id.
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In 1970, the Legislature enacted ch. 397, F.S., governing the treatment and rehabilitation of drug
dependents.11 The following year, the Legislature enacted ch. 396, F.S., titled the “Myers Act” as the
state’s comprehensive alcoholism prevention, control, and treatment act, modeled after the federal
Hughes Act.12 In 1993, legislation combined ch. 396 and ch. 397, F.S., into a single law, the Hal S.
Marchman Alcohol and Other Drug Services Act (“the Marchman Act”).13 The Marchman Act supports
substance abuse prevention and remediation through a system of prevention, detoxification, and
treatment services to assist individuals at risk for or affected by substance abuse.
Additionally, the Department of Children and Families (DCF) administers a statewide system of safety-
net services for substance abuse and mental health (SAMH) prevention, treatment, and recovery.
SAMH programs include a range of prevention, acute interventions (such as crisis stabilization or
detoxification), residential, transitional housing, outpatient treatment, and recovery support services.
Services are provided based upon state and federally-established priority populations and delivered
through community-based providers.14
DCF provides treatment for substance abuse through a community-based provider system that offers
detoxification, treatment and recovery support for adolescents and adults affected by substance
misuse, abuse or dependence:15
Detoxification Services: Detoxification services use medical and clinical procedures to assist
individuals and adults as they withdraw from the physiological and psychological effects of
substance abuse.16
Treatment Services: Treatment services17 include a wide array of assessment, counseling,
case management, and support that are designed to help individuals who have lost their
abilities to control their substance use on their own and require formal, structured intervention
and support. Some of these services may also be offered to the family members of the
individual in treatment.18
Recovery Support: Recovery support services, including transitional housing, life skills
training, parenting skills, and peer-based individual and group counseling, are offered during
and following treatment to further assist individuals in their development of the knowledge and
skills necessary to maintain their recovery.19
DCF regulates substance abuse treatment by licensing individual treatment components under ch. 397,
F.S., and rule 65D-30, F.A.C. Licensed service components include a continuum of substance abuse
prevention,20 intervention,21 and clinical treatment services.22 DCF uses a tier-based system of
11 Department of Children and Families, Marchman Act User Reference Guide 2003, https://www.myflfamilies.com/service-
programs/samh/crisis-services/docs/marchman/marchmanacthand03p.pdf (last visited April 16, 2021).
12 Id.
13 Ch. 93-39, s. 2, Laws of Fla., codified in ch. 397, F.S.
14 These priority populations include, among others, persons diagnosed with co-occurring substance abuse and mental health
disorders, persons who are experiencing an acute mental or emotional crisis, children who have or are at risk of having an emotional
disturbance, and children at risk for initiating drug use.
15 Department of Children and Families, Treatment for Substance Abuse, https://www.myflfamilies.com/service-
programs/samh/substance-abuse.shtml (last visited April 16, 2021).
16 Id.
17 Id. Research indicates that persons who successfully complete substance abuse treatment have better post-treatment outcomes
related to future abstinence, reduced use, less involvement in the criminal justice system, reduced involvement in the child-protective
system, employment, increased earnings, and better health.
18 Supra, note 15.
19 Id.
20 Section 397.311(26)(c), F.S. Prevention is a process involving strategies that are aimed at the individual, family, community, or
substance and that preclude, forestall, or impede the development of substance use problems and promote responsible lifestyles. See
also, Department of Children and Families, Substance Abuse: Prevention, https://www.myflfamilies.com/service-
programs/samh/prevention/index.shtml (last visited April 16, 2021). Substance abuse prevention is best accomplished through the use
of ongoing strategies such as increasing public awareness and education, community-based processes and evidence-based practices.
These prevention programs are focused primarily on youth, and, in recent years, have shifted to the local level, giving individual
communities the opportunity to identify their own unique prevention needs and develop action plans in response. This community focus
allows prevention strategies to have a greater impact on behavioral change by shifting social, cultural and community environments.
21 Section 397.311(26)(b), F.S. Intervention is structured services directed toward individuals or groups at risk of substance abuse and
focused on reducing or impeding those factors associated with the onset or the early stages of substance abuse and related problems.
22 Section 397.311(25), F.S.
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classifying violations and may issue administrative fines up to $500 for violations committed by a
licensee.23
Clinical treatment is a professionally directed, deliberate, and planned regimen of services and
interventions that are designed to reduce or eliminate the misuse of drugs and alcohol and promote a
healthy, drug-free lifestyle.24 “Clinical treatment services” include, but are not limited to, the following
licensable service components: 25
Addictions receiving facility.
Day or night treatment.
Day or night treatment with community housing.
Detoxification.
Intensive inpatient treatment.
Intensive outpatient treatment.
Medication-assisted treatment for opiate addiction.
Outpatient treatment.
Residential treatment.
Recovery Residences
Recovery residences (also known as “sober homes” or “sober living homes”) are alcohol- and drug-free
living environments for individuals in recovery who are attempting to maintain abstinence from alcohol
and drugs.26 These residences offer no formal treatment (though they may mandate or strongly
encourage attendance at 12-step groups) and are self-funded through resident fees.27
Section 397.311(37), F.S., defines a recovery residence as a residential dwelling unit, or other form of
group housing, offered or advertised through any means, including oral, written, electronic, or printed
means, by any person or entity as a residence that provides a peer-supported, alcohol-free, and drug-
free living environment.
Recovery residences can be located in single-family and two-family homes, duplexes, and apartment
complexes. Most recovery residences are located in single-family homes, zoned in residential
neighborhoods.28
Benefits of Recovery Residences
Multiple studies have found that individuals in recovery benefit from residing in a recovery residence.
For example, individuals in recovery residing in an Oxford House, a very specific type of recovery
residence, had significantly lower substance use, significantly higher income, and significantly lower
incarceration rates than those individuals who participate in usual group care.29
23 Section 397.415, F.S.
24 Supra, note 22.
25 Section 397.311(25)(a), F.S.
26 Douglas L. Polcin, Ed.D., MFT, and Diane Henderson, B.A., A Clean and Sober Place to Live: Philosophy, Structure, and Purported
Therapeutic Factors in Sober Living Houses, 40(2) J Psychoactive Drugs 153–159 (June 2008).
27 Id.
28 Hearing before the Subcommittee on the Constitution and Civil Justice of the Committee on the Judiciary, House of Representatives,
One Hundred Fifteenth Congress, Sept. 28, 2018, https://www.govinfo.gov/content/pkg/CHRG-115hhrg33123/html/CHRG-
115hhrg33123.htm. See also The National Council for Behavioral Health, Building Recovery: State Policy Guide for Supporting
Recovery Housing (2017), https://www.thenationalcouncil.org/wp-content/uploads/2018/05/18_Recovery-Housing-
Toolkit_5.3.2018.pdf?daf=375ateTbd56 (last visited April 16, 2021).
29 An Illinois study found that those in the OHs had lower substance use (31.3% vs. 64.8%), higher monthly income ($989.40 vs.
$440.00), and lower incarceration rates (3% vs. 9%). OH participants, by month 24, earned roughly $550 more per month than
participants in the usual-care group. In a single year, the income difference for the entire OH sample corresponds to approximately
$494,000 in additional production. In 2002, the state of Illinois spent an average of $23,812 per year to incarcerate each drug offender.
The lower rate of incarceration among OH versus usual-care participants at 24 months (3% vs. 9%) corresponds to an annual saving of
roughly $119,000 for Illinois. Together, the productivity and incarceration benefits yield an estimated $613,000 in savings per year, or
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Oxford House (OH) is a non-profit organization that rents out single-family homes for
individuals recovering from addiction. The OH model is a recovery residence of six to fifteen
residents that is democratically run, self-supporting, and drug free.30 Each OH recovery
residence operates pursuant to a charter issued by the OH organization. Three or more OHs
within a 100-mile radius make up one OH chapter. A representative from each house meets
with the others on a monthly basis to exchange information, seek resolution of problems in a
particular house, and express